Teams involved in offering inpatients psychiatric treatment are often subject to internal misunderstandings and intense feelings of rivalry and powerlessness. This can damage their ability to offer effective treatment to patients. A classic article, The Ailment by Tom Main, gives an account of an investigation of the experience of nurses treating a group of patients who evoked such feelings and offers a psychoanalytic understanding of the dynamics that underlie such difficulties. It is suggested that teams treating children and adolescents are particularly prone to outbreaks of The Ailment. There is a continuing need to create an atmosphere of trust and respect in which team members are encouraged to be open with each other. Such openness is essential if we are to be able to offer an effective experience of containment in which our patients can be helped to move towards healthier psychological functioning.
[Republished in Bion, W.R.Second thoughts. London: Heinemann.]
2.
Flynn, D.
(1999). The challenges of in-patient work in a therapeutic community. In M. Lanyado & A. Horne (Eds.), The handbook of child and adolescent psychotherapy (pp. 167-181). London: Routledge.
3.
Kennard, D.
(1998). An introduction to therapeutic communities. London: Jessica Kingsley.
4.
Lanyado, M.
(2001). Daring to try again: The hope and pain of forming new attachmentsTherapeutic Communities, 22(1), 5-18.
5.
[Republished in The Ailment and other psychoanalytic essays. London: Free Association Books, 1989.]
6.
Marsden, P.
(2001). Food and violence: Childhood violence and emotional abuse as complicating factors in the inpatient treatment of eating disorders. Psychoanalytic Psychotherapy, 15(3), 221-238.
7.
Santos, A.
, & Hinshelwood, R.D. (1998). The use at the Cassell of the organisational dynamics to enhance the therapeutic work. Therapeutic Communities, 19(1), 29-39.
8.
Spielman, R.
(1998). ‘The Ailment’ by T.F. Main – 40 years on. Therapeutic Communities, 19(3), 221-226.
